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You have to be setting up, in essence, a new enterprise to provide one million New Yorkers with health insurance.

New York State contemplates health care exchanges

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The State Senate held a panel discussion with major health care stakeholders, on how New York will implement the federal health care reforms proposed by President Obama and passed by Congress. In Albany, Karen DeWitt filed this report:

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Karen DeWitt
NYS Capitol Correspondent

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The State Senate held a panel discussion with major health care stakeholders, on how New York will implement the federal health care reforms proposed by President Obama and passed by Congress.

The federal health care reform act requires states to set up health care exchanges to give the uninsured access to the health care that they will be required to buy when the new law takes effect in 2014.

Senate Health Committee Chair Kemp Hannon says the exchanges will provide information about “who the insurers are and what the plans are.”

“You have to be setting up, in essence, a new enterprise to provide one million New Yorkers with health insurance,” said Hannon, who said the federal government will also require varying levels of plans. 

Senator Hannon, along with Senate Insurance Committee Chair Jim Seward, sponsored a forum, which brought together representatives from leading health insurance companies, as well as business and consumer advocates to begin to figure out how to implement the changes.

Some on the panel advocate creating a new public authority to implement the health care exchanges for the nearly one million uninsured New Yorkers. The other choices include using an existing state agency to run the exchanges, or set up a private not for profit entity. Advocates of the public authority model say state agencies are too bureaucratic, and might be slow to react, while a private entity might not be accountable to the public. Jim Tallon, is with United Hospital Fund, a health services research and philanthropic center, and a respected voice in New York’s health care policy circles. He says a public authority could be a viable compromise.

“This has kind of been the consensus way of bridging left and right,” said Tallon. “Bridging government and markets in this discussion.”

Tallon says recent public authority reforms passed by the legislature could also help guarantee that a new authority would be accountable to the public.

State lawmakers will also have to decide whether all of the state’s around one million uninsured will be in a single pool of policy holders, or whether the individual market will be split off from the small business market. The vast majority of people who work for larger corporations and the public sector obtain health insurance through their employer and would not immediately be affected by the exchanges.

Mark Scherzer, with New Yorkers for Accessible Health Coverage, and the health care consumer advocate on the panel, says both groups need to be in one pool. Otherwise, he says, those in the individual policy market, who often suffer from chronic diseases and can’t work, will have to pay for a disproportionate share of their care.

“You’ve shifted the cost of being sick to the sick people,” said Scherzer. “Which kind of defeats the purpose of insurance.”

Ken Pokalsky, with the State Business Council, says small business also “struggle” with out- of- control insurance premium costs, and will need guarantees that they won’t be priced out of the exchanges.

He says his members list the high cost of health care as their “number one concern” in doing business in New York.

New York State requires more procedures and treatments be covered by health insurance than most other states.

Senate Insurance Committee Chair Jim Seward says it’s important that lawmakers not delay, and at least get the structure of the exchanges approved during this year’s legislative session, and then fill in the details later.

“We need to get going, at least on the basic structure,” said Seward.

It’s possible that the federal courts could throw out the requirement that each American must purchase a health care plan, the US Supreme Court won’t be considering the case until sometime in 2012, but Senate Health Committee Chair Hannon says that won’t mean that setting up the exchange will be a waste of time. Hannon, a Republican, says the exchanges, after all, were originally an idea that came from conservatives. And he says they could help promote New York’s own plan for the uninsured, Healthy New York, which offers coverage, with some restrictions.

While some are welcoming the federal health law changes as a way to restructure the state’s health care system for the uninsured, Senator Hannon says he believes it’s also important to be cautious, and follow the old medical adage first,  “don’t do any harm.”

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